Systemic Lupus erythromatosis associated Glomerular Diseases
Systemic lupus erythematosus (SLE) is an autoimmune disorder affecting multiple organ systems including kidney, skin, lung, heart, the hematopoietic system and brain, Glomerulonephritis (GN) is a term used to refer to several kidney diseases (usually affecting both kidneys). Many of the diseases are characterized by inflammation either of the glomeruli or of the small blood vessels in the kidneys, also Glomerulonephritis leading to severe persistent proteinuria, chronic renal failure and end-stage renal disease which remains one of the most severe complications of SLE and its associated with significant morbidity and mortality.
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A combination of systemic autoimmunity and tissue response to immune injury underlie renal involvement in lupus erythematosus. In lupus glomerulonephritis, glomerular immune complexes were believed to be the primary mediators of renal disease. Recent studies make it apparent that autoantibodies of multiple specificities participate in the formation of immune complexes, deposited in the kidneys. Renal infiltration by T cells, macrophages, and dendritic cells have a dominant role in the progression of lupus glomerulonephritis leading to renal failure. Activation of Tolllike receptors modulates autoantibody production and systemic interferon responses. However, glomerular cell responses to immune injury influence disease outcome. In addition, new insights on the genetics of susceptibility to end-organ damage in lupus glomerulonephritis have been discovered. Lupus glomerulonephritis is a prototype of immune complex disease mediated by autoantibodies of multiple specificities, one of which is anti-DNA. Murine models of spontaneous systemic lupus erythematosus have been critical for understanding the underlying disease. Recent studies demonstrate that in addition to systemic autoimmunity, end-organ responses, and endorgan resistance to damage are also critical in determining disease outcome. This understanding should influence design of novel therapeutic approaches in systemic lupus erythematosus
